Colostomy appliance



April 13, 1954 D. J. CESARE COLOSTOMYAPPLIANCE Filed June 4, 1951 C m M5 Patented Apr. 13, 1954 UNITED STATE S PATENT OFFICE Thi inventionrelates to an appliance for use by persons who have undergone acolostomy or ileostomy. More specifically it has reference to a devicefor protecting the stoma against injury and prolapse, and to providesupport for the stoma.

Where, in the following description and claims, I employ the wordcolostomy, I intend the same to refer also to an ileostomy, the medicaldistinction between the terms not being regarded as significant insofaras the invention is concerned.

Frequently the stoma protrudes a substantial distance exteriorly of theabdomen, sometimes as much as several inches, and in a suspendedposition. Accordingly, if the individual rolls over while asleep thestoma may be injured or subjected to painful pressure. Even the actionof coughing has the effect of agitating the stoma and with consequentpain. Moreover, a vigorous cough, sneezing or extraordinary physicalexertion may cause prolapse of the stoma.

It will be understood that individuals who are obliged to defecatethrough a segment of the colon or ilium which protrudes through theabdominal wall are required to wear constantly a bag or pouch, and thatsuch bag is supported upon a belt. Most common of these is that form ofbag which is provided at its upper open end with a rubber covered,rigid, annular member through the opening of which the stoma ispositioned for emptying into the bag. The annular member is maintainedin sealed contact with the persons body by means of a belt linked withhooks forming part of a retaining ring juxtaposed to the member. Howeverin this form of appliance, as well as others less commonly used, thestoma has no protection beyond that afforded by the rubber or plasticmaterial composing the bag, and such material being completely flexibleis of no value in protecting the stoma against in jury or prolapse.

It is therefore one of the principal objects of the invention to providea rigid member adapted to be mounted in conjunction with the bag, and soarranged as to guard the stoma against inury.

Another object is to provide a guard as aforesaid which is instrumentalalso in arresting prolapse.

A further object is to provide a guard as noted which includes a rigidpart to protect the stoma from injury due to pressure exerted fromwithout and yieldable means which, while supporting the stoma, willpermit necessary normal movementthereof, as in emptying of the bowel.

12 Claims. (01. 128-283) 1 Still another object is to provide a deviceas aforesaid in which the yieldable means is so constructed andarranged, as to provide support for the stoma and additionally toprotect the I same without blocking the opening thereof.

Another object is to provide yieldable means as stated which isadjustable for different individuals in whom the stoma is variouslydisposed.

An additional object resides in providing, in

one form of an appliance as aforesaid, means by which the force exertedby the spring is readily adjustable depending upon the characteristicsof the stoma.

Generally regarded, the invention, in one prewferred embodiment,contemplates the provision of a rigid member arranged to be retained inpredetermined relation with the bag and so coniormed as to provide abridge over the stoma. Mounted on the bridge is a hinged elementtogether with bias means normally to position the element for protectingthe stoma while allowing normal movements thereof. Additionally therelatively fixed part of the hinged element may be carried pivotally onanother axis to permit lateral arcuate adjustment of the element inaccordance with the disposition of the stoma. In another aspect the,invention may take the form ofa simple cup-shaped element adapted tobear gently but firmly on the stoma and influenced into such position bya compression spring secured at one end to the element and at the otherend to the bridge.

,In the drawing, which depicts certain forms which the invention mayassume in practice;

; Fig. l is a front elevational view of the bag and of the inventionimprovement in operative relation therewith;

Fig. 2 is a longitudinal cross-sectional view taken on the line 2--2 ofFig. 1, and on an enlarged scale;

Fig. 3 is a side elevational view showing details of the invention;

Fig. 4 is a transverse cross section taken along the line 4-4 of Fig. 1;and

Fig. 5 is a plan view of a modified form of the invention.

Referring to Figs. 1 to 4, the bag unit proper Ill is indicated as beingpositioned on the persons body H, while the stoma is shown at I12.Inasmuch as the bag in general is the same as that disclosed for examplein United States Letters Patent No. 2,048,392, the same will not be elaborated upon beyond pointing out those parts thereof with which theinvention device is intended to cooperate. i l

Serving as a supporting means for the bag I is a rigid annular member 15having a pair of laterally opposed hooks Iii-I6 for receiving the linkslll7 at the ends of the body-embracing belt 18. Arranged to be receivedintermediate the annulus l and links it are the two cars i9l9 of abridge member 22. If desired the abutting faces of the annulus I5 andears l9-I9 may be correspondingly deformed, as by dimpling, to increasefrictional engagement therebetween.

It will be seen that the bridge 22, which is preferably of stiff metal,is curved outwardly, in lateral aspect, to form an arch 23, andv that inanterior aspect the arch 23 is of arcuate configuration to define anarea therebelow for the parts to be described. The degree to which thearch is offset at its point of greatest forward displacement will dependupon the individual case, but in any event will be sufiiciently curvedso as not to present any firm surface against which the stoma may bepressed, as might occur if the wearer were to roll over While in bed.Moreover the upward arcuity will also contribute in providing clearancefor normal movement of the stoma.

Mounted for swinging movement upon a pivot 26 secured to the arch 23 isa hinge part or guard 21. To permit manual adjustment of the part 27without the use of tools and to maintain such selected positionfrictionally a wave washer or dished washer 29 may be interposed.Alternatively the part 27 may be arranged in simple contiguous relationwith a central, flattened portion of the arch 23 and friction betweenthe contactihg surfaces depended upon to maintain the set ting.Additionally serrations or an equivalent expedient may be provided onthe opposed faces toimplement the frictional engagement, or a settingonce made may be permanently maintained by riveting or other fastening.

Hinge part 27 is provided with a pair of apertured lugs 3l-3i throughwhich a pin 32 is secured as by peening over its ends. In turn themovable hinged part 34 is provided with lugs 35-45 also pivotallyengaging the pin 32.. For biasing part 34 posteriorly there is provideda torsion spring 36 coaxial with the pin 32 and having its radiallyextending ends engaging the two hinge parts as will be understood.Springs is so designed as to furnish just sufficient force to preventprolapse of the stoma and to yield with movements thereof, but not of adegree to cause annoyance or pain to the person.

Hinge member 34- is preferably of the form shown in order to performitsintended functions, and preferably comprises a somewhat cup-shaped.elementhaving an arouate forward wall it, and an arcuate lower wall 42,in order to conform as closely as possible to the contour of thedepending stoma. Of particular importance is to so conform the. member34 as to provide proper support without interference with elimination. Ihave found that the arcuate. bottom and front walls offer a fullyacceptable configuration, the sloping side edges of the. front wallallowing the material exiting from the stoma to find passages at bothsides of the guard 34 or at the bottom thereof. From. Fig-2 it will beobserved that the posterior biasing of the guard may, to some extentpress together the walls of the bag l0. However if this should occur,and delivery intothe bag, impeded slightly, the; manner in which thewalls of the bag may be foldedwillstill, pro

vide channels at both sides of the guard, and as will be clear from Fig.4.

In use, any induced movement of the stoma, such as would be induced byexertion, coughing, sneezing, elimination or otherwise will simply causehingingmovement of the guard 34 against bias of the spring, and withoutsacrificing the continuous support the guard is intended to provide.Furthermore, any inclination of the stoma to prolapse will beeffectively counteracted. Additionally the guard will tend to limit theprotrusion of the stoma beyond the abdominal wall. It will be understoodthat excessive protrusion 1 thereof will expose more of the tissues topossible injury.

Of importance is the function of the guard in decelerating theelimination process, which when diarrheal in nature, is debilitating.

By mounting the invention improvement exteriorly of the bag no metal maytouch the stoma to cause irritation, whereas the interposed relativelysoft and pliable material of the bag presents a cushion between theguard and flesh. Thus the annoyance of cleaning the device. at frequentintervals is avoided. Moreover any necessary folding of the bag as at5|5I to permitadaptation of the invention improvement is caught underthe bridge 22, and therefore is incapable of adding unsightly bulk tothe appliance as a whole.

Alternatively the spring 35 and the hinging' of, the member 34 may bedispensed with, and the latter rigidly secured to the bridge 22, andwith or without means for lateral angular adjust- 'ment thereof.

A modified form of the invention, particularly adapted to stomas whichprotrude without depending, is i-llustrated' in Fig.. 5, and, forclarity, is shown as disassociated from the bag proper. In this case thebridge 22a. is so conformed as to present a central point, regarded in avertical sense, substantially opposite the approximate end of the stoma.At such central point a rivet 55 secures a button 56 to which thesmaller end of a. conical compression spring is secured. At its largerend the spring carries a dished element 51 which is secured to thespring by means of struckout lugs thereof or otherwise. It will becomprehended that the stoma is constrained. by the element 51 inananterior-posterior sense as well as a, lateral sense. Preferably theelement 51 is suitably perforated so as not toblock elimination.

WhileIhave-shown particular embodiments of my invention, it will beunderstood, of course, that I do not wish to be limited thereto, sincemany modifications may be made, and I. therefore contemplate by theappended claims tocover any such modifications as fall within, the truespirit and scope. of my invention.

Having thus described my invention, what. I claim. and desire to secureby Letters Patent is:

l. A colostomy appliance for the purpose described and adapted for usewith a colostomy bag having means for supporting the bag on the body ofthe wearer comprising a member conformed to bridge over the stoma andincluding means for association with the bag-supporting means formaintaining the member in a predetermined relation to the stoma, andarigid cup-shaped element resiliently supported on said member includinga substantially segmentally cylindrical portion having its axissubstantially vertical and 'asubstantially segmentally spherical floorportion opening; upwardly and cojoined thereto together, and soconformed and positioned as to receive the weight and to oppose theprolapsive tendency of the stoma for maintaining a comfortabledisposition thereof and to protect the same against injury.

A colostomy appliance for the purpose described and adapted for use witha colostomy bag having means for supporting the bag on the body of thewearer comprising a member conformed to bridge over the stoma andincluding means for association with the bag-supporting means formaintaining the member in predetermined relation to the stoma, acup-shaped element including a substantially segmentally cylindricalportion having its axis substantially vertical and a substantiallysegmentally spherical floor portion opening upwardly and cojoinedthereto together adapted to receive the weight and to oppose theprolapsive tendency of the stoma to support and protect the same againstinjury, and hinge means interconnecting said element member.

3. A colostomy appliance as recited in claim 2 further characterized bythe provision of resili ent means intermediate said member and elementfor biasing said element into operative relation with the stoma.

4. A colostomy appliance for the purpose described and adapted for usewith a colostomy bag having means for supporting the bag on the body ofthe wearer comprising a member conformed to bridge over the stoma andincluding means for association with the bag-supporting means formaintaining the member in predetermined relation to the stoma, a guardmember adapted to bear against the stoma for supporting the same and forprotecting the same against injury, and pin and aperture means forconnecting said guard member to said bridging member for lateral pivotaladjustment of said guard member relative to said bridging member.

5. A colostomy appliance as recited in claim 4 further characterized inthat said connecting means is also provided with a friction device forpreserving a selected position of said guard memher.

6. A colostomy appliance for the purpose described and adapted for usewith a colostomy bag having a rigid part for contact with the wearer anda flexible bag carried by said part and which part is provided with apair of opposed hooks for engagement with a belt which encircles thebody of the wearer comprising a member exteriorly of the bag havingopposed portions for engagement with the hooks and belt for retainingthe member in a predetermined position relative to the stoma, saidmember hav ing an arched configuration to overlie and protect the stoma,an element supported by said member positioned contiguous to the stoma,and resilient means for urging said element against the stoma.

7. A colostomy appliance as recited in claim 6 in which the support forsaid element includes a hinge intermediate said member and element andsaid resilient means includes a spring intermediate said member andelement.

8. A colostomy appliance as recited in claim 6 in which the support forsaid element comprises a pivotal connection between said member andelement for angular adjustment of said element about ananterior-posterior axis.

9. A colostomy appliance as recited in claim 6 in which the support forsaid element comprises a pivotal connection between said member andelement for angular adjustment of said element about ananterior-posterior axis and hinge means for angular movement of saidelement about a lateral axis.

10. A colostomy appliance as recited in claim 9 in which the resilientmeans comprises a torsion spring incorporated with the hinge means andco-axial with the hinge axis.

11. A colostomy appliance for the purpose described and adapted to besupported jointly with a colostomy bag upon the body-embracing beltassociated with the bag comprising arcuate member having portions forengagement with the belt, said arcuate member having a configurationsuch as to bridge the stoma and to protect the same against injury, anelement carried on said member by pin and aperture means for movementabout a laterally-extending axis, said element having a cup-shapedportion including a substantially segmentally cylindrical portion havingits axis substantially vertical and a substantially segmentallyspherical floor portion opening upwardly and cojoined thereto togetheradapted for receiving the stoma and for additional protection thereof,and resilient means intermediate said member and element for urging saidportion against the stoma.

12. A colostomy appliance for the purpose described and adapted to besupported jointly with a colostomy bag upon the body-embracing beltassociated with the bag comprising a member having portions forengagement with the belt, said member having an arched configuration tooverlie and protect the stoma, a cup-shaped element carried by saidmember including a substantially segmentally cylindrical portion havingits axis substantially vertical and a substantially segmentallyspherical floor portion opening upwardly and cojoined thereto togetheradapted to apply pressure against the stoma to retain the same in apredetermined position, and resilient means intermediate said member andelement for cushioning the stoma against the natural reflex movementsthereof.

References Cited in the file of this patent (1st addition to No.661,442)

